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 Schistosomiasis affects at least 250 million people. It is caused by
parasitic worms, picked up in infested waters, which drill through
people's skin and lay eggs in their bodies.
If the worms lay eggs in a woman's genital areas, including the
vagina and cervix, they can cause lesions which make women more
vulnerable to HIV, experts in the tropical disease said.
Women are three times more likely to be infected with HIV if they
have female genital schistosomiasis (FGS), studies carried out in
Zimbabwe, Tanzania, South Africa and Mozambique have found.
"It's going completely under the radar," Marianne Comparet, director
of the London-based International Society for Neglected Tropical
Diseases (ISNTD), said in an interview.
"Treating one could really impact on the other," she told the
Thomson Reuters Foundation.
Men with the worms in their genitals show a sharp increase in the
amount of HIV virus in their semen, researchers said.
The treatment for schistosomiasis is cheap - the drug has been
donated for years to the World Health Organization (WHO), so this
could be a relatively easy way to help cut the spread of HIV,
experts said.
"In the same way that circumcision came out as something that really
changed the way people approached HIV transmission, this could
really be the next big thing in controlling HIV transmission,"
Comparet said.
Circumcision has been found to cut the spread of HIV among
heterosexuals and is recommended by the WHO as a means of
prevention.
Nearly 37 million people live with HIV, the majority in Africa.
A LITTLE-KNOWN DISEASE
It is not known how many people have FGS, but estimates range from
20 million to 80 million, the vast majority in Africa.
According to the WHO, most cases of FGS are undiagnosed and few
medical staff are aware of its existence. It gets no mention in
medical textbooks or nursing curricula in any of the countries where
schistosomiasis is endemic, WHO says.
The U.N. agency recommends the regular treatment of young girls
through mass drug administration in schools and communities to
prevent FGS from developing.
Treatment kills adult worms but it cannot reverse damage they have
already done to people's organs and tissues.
"It starts early on, and then when you are a young woman, without
any treatment it becomes really serious, and when women become
sexually active they are very vulnerable to HIV," Jutta Reinhard-Rupp
at Merck Serono said in an interview.
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Merck Serono produces praziquantel, the only treatment available for
schistosomiasis.
FGS can also cause other complications including infertility and
ectopic pregnancies.
The link between FGS and HIV is very difficult to prove in a
clinical study because it not possible to have a control group that
is left untreated, Reinhard-Rupp said.
Another possible link is between schistosomiasis in men's genitals
and the spread of the HIV virus.
Men with both diseases had an HIV viral load in their semen 10 times
bigger than that of men without schistosomiasis, according to
initial findings from a small-scale study carried out in Zimbabwe
last year.
After treatment for schistosomiasis, the viral load returned to
normal levels.
The findings will be made public at the ISNTD Coinfections
conference in London on Friday.
Many countries in southern Africa are seriously affected by both
schistosomiasis and HIV, Peter Leutscher, who is a professor at
Aarhus University Hospital and helped carry out the research, said
in a telephone interview.
"This overlap of HIV and schistosomiasis is really striking," he
told the Thomson Reuters Foundation.
"It's a neglected risk factor" in the fight against HIV, he said.
Leutscher wants genital schistosomiasis to be included alongside
other risks involved in the spread of HIV like the number of sexual
partners, condom use, circumcision, and other sexually transmitted
diseases.
(Reporting by Alex Whiting, editing by Tim Pearce.; Please credit
the Thomson Reuters Foundation, the charitable arm of Thomson
Reuters, that covers humanitarian news, women's rights, trafficking,
corruption and climate change. Visit http://news.trust.org)
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